Monday, May 28, 2012

"1 in 3 is obese--even the homeless"

This study definitely seems to back up many themes I have written about on this blog including food insecurity in the obese. It is pretty telling when 2 out of every 3 homeless people in this study are fat. In the old days, I guess the very poor out and out starved, so they grew thin and starved to death but today, many get food from sources where the food is highest in fat and calories and is carb rich and get into the feast and famine metabolic drops. One can see the effects here:

The paradox is that hunger and obesity can exist in the same person. And although a person may be overweight or obese, he or she can lack proper nutrition.

Nutrition is a daily challenge for homeless people, as the foods they manage to get are often full of preservatives and high in sodium, fats and sugars. They may not have access to healthier options like fresh fruits and vegetables.

"It's the lowest socio-economic group who has the biggest obesity problem," said Paul Montgomery, one of the authors of the study published in the Journal of Urban Health. "No one looked at the homeless problem before. What we found was this group has a significant obesity problem that wasn't known."

The obesity rate in a sample of 5,632 homeless adults seen at the Boston Health Care for the Homeless Program was similar to that seen in the general population.

"It just mirrors what Americans look like in general," said Barbara Dipietro, policy director of the National Health Care for the Homeless Council. "It follows the homeless in general. They are more economically driven. They are intact families and people who are coming into homelessness, who don't come with behavioral health issues. When we look at the homeless population, we think they're different, but they're like everyone else."

Two out of three homeless individuals were either overweight or obese. The study found that 32.6% were normal weight and that 1.6% was underweight.

"Although underweight has been traditionally associated with homelessness, this study suggests that obesity may have replaced underweight as the new malnutrition of the homeless," the authors wrote.

The researchers found that 5.6% of this population were morbidly obese, meaning they had BMIs greater than 40. A 250-pound man who stands at 5 feet and 7 inches would have a BMI of 40. A BMI over 25 is considered overweight; a BMI over 30 is obese.

In further analyses, homeless women (42.8%) were more likely to be obese than homeless men (29.7%).

"Our results are in line with [the] hunger-obesity paradox," said Montgomery. "People feel hungry. The body's response is the higher calories, you store them and become obese, and you still feel hungry. It's a circular problem."

The human body might be hoarding calories, as an adaptive response when people do not consistently have enough to eat. The body's response could contribute to obesity, by "becoming more efficient at storing more calories as fat," according to the report.